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CONTRACT NUMBER Armed Forces Institute of Regenerative Medicine Annual Report 2009 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) 8. PERFORMING ORGANIZATION Army Medical Research and Materiel Command,Armed Forces Institute REPORT NUMBER of Regenerative Medicine,504 Scott Street,Fort Detrick,MD,21702-5012 9. SPONSORING/MONITORING AGENCY NAME(S) AND ADDRESS(ES) 10. SPONSOR/MONITOR’S ACRONYM(S) 11. SPONSOR/MONITOR’S REPORT NUMBER(S) 12. DISTRIBUTION/AVAILABILITY STATEMENT Approved for public release; distribution unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT 15. SUBJECT TERMS 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF 18. NUMBER 19a. NAME OF ABSTRACT OF PAGES RESPONSIBLE PERSON a. REPORT b. ABSTRACT c. THIS PAGE Same as 260 unclassified unclassified unclassified Report (SAR) Standard Form 298 (Rev. 8-98) Prescribed by ANSI Std Z39-18 AArrmmeedd FFoorrcceess IInnssttiittuuttee ooff RReeggeenneerraattiivvee MMeeddiicciinnee Annual Report 2009 COL Robert Vandre AFIRM Project Director [email protected] TTTTTTTTaaaaaaaabbbbbbbblllllllleeeeeeee ooooooooffffffff CCCCCCCCoooooooonnnnnnnntttttttteeeeeeeennnnnnnnttttttttssssssss EEExxxeeecccuuutttiiivvveee SSSuuummmmmmaaarrryyy.............................................................................................................................................................................................................................................................................................................................................................................................................................................v I Introduction I-1 Background..................................................................................................................................................................................................................................................................................................................................................I-1 RReesseeaarrcchh GGooaallss......................................................................................................................................................................................................................................................................................................................................I-2 History..................................................................................................................................................................................I-3 Funding – A Six-Way Partnership......................................................................................................................................I-4 Structure..............................................................................................................................................................................I-4 Management and Oversight...............................................................................................................................................I-5 II Limb and Digit Salvage II-1 Background........................................................................................................................................................................II-1 Unmet Needs......................................................................................................................................................................II-2 Areas of Emphasis.............................................................................................................................................................II-2 Bone Repair and Regeneration........................................................................................................................................II-3 Soft Tissue Repair and Regeneration (excluding nerve)..................................................................................................II-4 Nerve Repair and Regeneration.......................................................................................................................................II-6 Composite Tissue Injury Repair........................................................................................................................................II-7 Transplantation.................................................................................................................................................................II-8 Epimorphic Regeneration (and associated methods).......................................................................................................II-8 Progress Reports Bone Repair and Regeneration Project 4.2.1, RCCC–Optimizing Scaffolds for Repair ofBone Defects.....................................................................II-10 Project 4.2.2, RCCC–Optimizing Cell Sources for Repairof Bone Defects................................................................II-14 Project 4.2.3, RCCC–Advancing Bone Repair Using Molecular Surface Design.......................................................II-18 Project 4.2.4, RCCC–Clinical Assessment of Ongoing Strategies for Treatment of Bone Defects.............................II-22 Soft Tissue Repair and Regeneration (excluding nerve) Project 4.3.2, RCCC–Development of a Tissue-Lined Bioabsorbable Stent Graft for Treatment of Arterial Trauma........................................................................................................................II-24 Project 4.4.3a, RCCC–Functional Scaffold for Musculoskeletal Repair and Delivery of Therapeutic Agents............II-27 Project 4.4.3b, RCCC–Functional Scaffolds for Soft Tissue Repair...........................................................................II-30 Project 4.4.6, WFPC–Oxygen-Generating Biomaterials for Large Tissue Salvage....................................................II-33 Nerve Repair and Regeneration Project 4.4.1, RCCC–Optimizing Nerve Conduit Scaffolds for the Repair of Segmental Nerve Defects....................II-36 Project 4.4.2, RCCC–Cell and Bioactive Molecular Delivery to Enhance the Repair of Segmental Nerve Defects...II-36 Project 4.4.1a, RCCC–Optimizing Nerve Conduit Scaffolds for the Repair of Segmental Nerve Defects Developing Biodegradable Polyester “Biorubber” Nerve Regeneration Conduits......................................................II-41 Project 4.4.1b, RCCC–Optimizing Nerve Conduit Scaffolds for the Repair of Segmental Nerve Defects..................II-44 Project 4.4.2a, RCCC–Cell and Bioactive Molecule Delivery to Enhance the Repair of Segmental Nerve Defects...........................................................................................................................II-47 Project 4.4.4, WFPC–Peripheral Nerve Repair...........................................................................................................II-50 Project 4.4.5, WFPC–Modular, Switchable, Synthetic, Extracellular Matrices for Regenerative Medicine.................II-53 Composite Tissue Injury Repair Project 4.4.3, WFPC–Engineered Delivery of Spatial and Temporal Cues for Composite Tissue Injury Repair........II-57 AFIRM Annual Report 2009 i TTTTTTaaaaaabbbbbblllllleeeeee ooooooffffff CCCCCCoooooonnnnnntttttteeeeeennnnnnttttttssssss II Limb and Digit Salvage (cont.) II-1 Transplantation Project 4.4.2, WFPC–HHaanndd TTrraannssppllaannttaattiioonn ffoorr RReeccoonnssttrruuccttiioonn ooff DDiissaabblliinngg UUppppeerr LLiimmbb BBaattttlleefifieelldd TTrraauummaa –– TTrraannssllaattiioonnaall aanndd CClliinniiccaall TTrriiaallss..................................................................................................................II-61 Epimorphic Regeneration Project 4.4.1, WFPC–Blastemal Approach to Digit Reconstruction............................................................................II-64 Project 4.4.7, WFPC–High-Throughput Technologies to Study Limb Regeneration...................................................II-67 Project 4.4.8, WFPC–Magnetophoretic Cell Sorting for Transplant Therapies...........................................................II-71 III Craniofacial Reconstruction III-1 Background.......................................................................................................................................................................III-1 Unmet Needs.....................................................................................................................................................................III-2 Areas of Emphasis............................................................................................................................................................III-2 Bone Regeneration..........................................................................................................................................................III-3 Soft Tissue Regeneration................................................................................................................................................III-5 Skeletal Muscle and Nerve Replacement........................................................................................................................III-6 Cartilage Regeneration (Focus: Ear)...............................................................................................................................III-7 Virtual Modeling for Craniofacial Reconstruction.............................................................................................................III-8 Progress Reports Bone Regeneration Project 4.5.1, RCCC–Regeneration of Bone in the Cranio-Mandibulo-Maxillofacial (CMF) Complex.......................III-10 Project 4.1.2, WFPC–Space Maintenance, Wound Optimization, Osseous Regeneration, and Reconstruction for Craniomaxillofacial Defects.........................................................................................................III-15 Project 4.1.3, WFPC–Novel Synthetic Bone..............................................................................................................III-18 Soft Tissue Regeneration Project 4.3.1, RCCC–Composite Tissue Allograft (CTA) Transplantation Without Life-Long Immunosuppression...III-21 Projects 4.1.4 and 4.1.5, WFPC– Soft Tissue Regeneration (4.1.4)...............................................................................................................................III-24 Injectable and Implantable Engineered Soft Tissue for Trauma Reconstruction (4.1.5)............................................III-24 Skeletal Muscle and Nerve Replacement Project 4.1.2, RCCC–Develop Innervated, Vascularized Skeletal Muscle.................................................................III-28 Project 4.1.6, WFPC–Bioreactors and Biomaterials forTissue Engineering of Skeletal Muscle...............................III-31 Cartilage Regeneration (Focus: Ear) Project 4.5.4, RCCC–Regeneration of Ear................................................................................................................III-33 Project 4.1.1, WFPC–Engineered Cartilage-Covered Ear Implants for Auricular Cartilage Reconstruction..............III-36 Virtual Modeling for Craniofacial Reconstruction Project 4.5.5, RCCC–Virtual Reality Application for Modeling and Visualization of Patient-Specific Craniofacial Wounds and Injuries..............................................................................................................................III-39 ii AFIRM Annual Report 2009 IV Scarless Wound Healing IV-1 Background .......................................................................................................................................................................IV-1 Unmet Needs .....................................................................................................................................................................IV-2 Areas of Emphasis ............................................................................................................................................................IV-2 Control of Wound Environment Mechanics .....................................................................................................................IV-2 Therapeutic Cell/Molecular/Gene Delivery to Wounds ....................................................................................................IV-3 Attenuation of Wound Inflammatory Response ...............................................................................................................IV-5 Scar Mitigation .................................................................................................................................................................IV-6 Progress Reports Control of Wound Environment Mechanics Project 4.5.1, WFPC–A Device to Actively Control the Mechanobiology During Wound Healing and Prevent Scar Formation ...........................................................................................................................IV-8 Therapeutic Cell/Molecular/Gene Delivery to Wounds Project 4.5.2, WFPC–Regenerative Bandage for Battlefield Wounds .......................................................................IV-11 Project 4.5.5, WFPC–Scarless Wound Healing Through Nanoparticle-Mediated Molecular Therapies ....................IV-14 Project 4.6.3, RCCC–TLI and Promote Non-Scar Healing After Burns and Severe Battle Trauma: P12, Curcumin, and MSC Intravenous Treatment to Prevent Cutaneous Scarring ...................................................IV-17 Project 4.7.1, RCCC–Adipose-Derived Therapies for Wound Healing, Tissue Repair, and Scar Management ........IV-19 Attenuation of Wound Inflammatory Response Project 4.5.3, WFPC–Multi-Functional Bioscaffolds for Promoting Scarless Wound Healing ...................................IV-22 Project 4.5.4, WFPC–Regulation of Inflammation, Fibroblast Recruitment, and Activity for Regeneration ...............IV-25 Scar Mitigation Project 4.5.6, WFPC–Delivery of Therapeutic Compounds into Injured Tissue .........................................................IV-29 Project 4.5.7, WFPC–Scar Mitigation via Matrix Metalloproteinase-1 Therapy .........................................................IV-32 V Burn Repair V-1 Background ........................................................................................................................................................................V-1 Unmet Needs ......................................................................................................................................................................V-1 Areas of Emphasis .............................................................................................................................................................V-3 Intravenous Treatment of Burn Injury ...............................................................................................................................V-3 Topical Treatment of Burn Injury .......................................................................................................................................V-4 Wound Healing and Scar Prevention ...............................................................................................................................V-6 Skin Products/Substitutes.................................................................................................................................................V-7 Clinical Trials ......................................................................................................................................................................V-9 Progress Reports Intravenous Treatment of Burn Injury Project 4.6.1, RCCC–Prevent Burn Injury Progression, Reduce Inflammation, and Induce Healing in a Rat Hot Comb Model by Determining the Optimal Doses and Treatment Times for Systemically Administered MSCs, Curcumin, Pentoxifylline, and P12 ............................................................................................V-10 Project 4.6.2, RCCC–Bone Marrow-Derived Mesenchymal Stem Cell Intravenous Treatment to Prevent Burn Injury Progression .................................................................................................................................V-12 Topical Treatment of Burn Injury Project 4.6.4, RCCC–Topical Iodine Treatment of Burns to Prevent Infection ............................................................V-14 Project 4.6.5, RCCC–Topical P12 Treatment of Burns Using Fibroporous Mat ..........................................................V-17 Project 4.6.6, RCCC–Curcumin-Loaded Nanospheres as a Topical Therapy to Limit Burn Injury Progression and to Promote Non-Scar Healing .......................................................................................V-19 Project 4.2.3, WFPC–Novel Keratin Biomaterials That Support the Survival of Damaged Cells and Tissues ...........V-21 AFIRM Annual Report 2009 iii TTTTTTaaaaaabbbbbblllllleeeeee ooooooffffff CCCCCCoooooonnnnnntttttteeeeeennnnnnttttttssssss V Burn Repair (cont.) V-1 Wound Healing and Scar Prevention PPrroojjeecctt 44..22..22,, WWFFPPCC––DDeelliivveerryy ooff SStteemm CCeellllss ttoo aa BBuurrnn WWoouunndd vviiaa aa CClliinniiccaallllyy TTeesstteedd SSpprraayy DDeevviiccee........................V-24 Project 4.2.4, WFPC–AArrttiifificciiaall EExxttrraacceelllluullaarr MMaattrriixx PPrrootteeiinnss ffoorr RReeggeenneerraattiivvee MMeeddiicciinnee............................................V-27 PPrroojjeecctt 44..22..55,, WWFFPPCC––IInn SSiittuu BBiioo--PPrriinnttiinngg ooff SSkkiinn ffoorr BBaattttlleefifieelldd BBuurrnn IInnjjuurriieess............................................................V-29 Skin Products/Substitutes Project 4.7.2, RCCC–Burn Repair with Autologous Engineered Skin Substitutes......................................................V-31 Project 4.2.1a, WFPC–Tissue Engineered Skin Products..........................................................................................V-34 Project 4.2.1b, WFPC–Tissue Engineered Skin Products/Comparative Skin Study..................................................V-36 Project 4.2.6, WFPC–Amniotic Fluid Stem Cells forBurn..........................................................................................V-38 VI Compartment Syndrome VI-1 Background.......................................................................................................................................................................VI-1 Unmet Needs.....................................................................................................................................................................VI-1 Areas of Emphasis............................................................................................................................................................VI-2 Prevention/Early Treatment of Compartment Syndrome.................................................................................................VI-2 Cellular Therapy of Compartment Syndrome..................................................................................................................VI-3 Biological Scaffold-Based Treatment of Compartment Syndrome..................................................................................VI-4 Progress Reports Prevention/Early Treatment Project 4.1.1, RCCC–Compartment Syndrome Early-Stage Biomaterials-Based Therapies......................................VI-6 Cellular Therapy Project 4.3.1, WFPC–Cellular Therapy for the Treatment of the Consequences of Compartment Syndrome............VI-9 Project 4.3.2, WFPC–Autologous Bone Marrow-Derived Stem Cells to Treat Extremity Injury Complicated by Compartment Syndrome..................................................................................................................VI-12 Biological Scaffold-Based Treatment Project 4.3.3, WFPC–Biodegradable Elastomeric Scaffolds Microintegrated with Muscle-Derived Stem Cells for Fascial Reconstruction Following Fasciotomy...................................................................................VI-15 Project 4.3.4, WFPC–Use of Autologous Inductive Biologic Scaffold Materials for Treatment of Compartment Syndrome......................................................................................................................VI-18 Project 4.3.5, WFPC–Material-Induced Host Cell Recruitment for Muscle Regeneration.........................................VI-20 VII AFIRM Program Statistics VII-1 Introduction......................................................................................................................................................................VII-1 Personnel..........................................................................................................................................................................VII-1 Honors and Achievements..............................................................................................................................................VII-3 Publications and Presentations......................................................................................................................................VII-4 Inventions, Patent Applications, and Patents...............................................................................................................VII-4 Appendix A: Honors and Awards to AFIRM Faculty........................................................................................A-1 Appendix B: Peer-Reviewed Publications and Other Publications and Presentations................................B-1 Appendix C: Patent Applications and Invention Disclosures........................................................................C-1 Appendix D: Index of Team Leaders, Project Team Members, and Collaborators.......................................D-1 iv AFIRM Annual Report 2009 EEEEEEEEExxxxxxxxxeeeeeeeeecccccccccuuuuuuuuutttttttttiiiiiiiiivvvvvvvvveeeeeeeee SSSSSSSSSuuuuuuuuummmmmmmmmmmmmmmmmmaaaaaaaaarrrrrrrrryyyyyyyyy TTTThhhheeee uuuusssseeee ooooffff iiiimmmmpppprrrroooovvvviiiisssseeeedddd eeeexxxxpppplllloooossssiiiivvvveeee ddddeeeevvvviiiicccceeeessss iiiinnnn IIIIrrrraaaaqqqq aaaannnndddd AAAAffffgggghhhhaaaannnniiiissssttttaaaannnn hhaass ccaauusseedd aa mmaarrkkeedd iinnccrreeaassee iinn sseevveerree bbllaasstt ttrraauummaa.. DDuuee ttoo aaddvvaanncceess iinn bbooddyy aarrmmoorr,, qquuiicckkeerr eevvaaccuuaattiioonn ffrroomm tthhee bbaattttlleefifieelldd,, aanndd aaddvvaanncceedd mmeeddiiccaall ccaarree,, mmaannyy ooff tthhee iinnjjuurreedd ssuurrvviivvee ttoo ffaaccee tthhee cchhaalllleennggee ooff oovveerrccoommiinngg sseevveerree lliimmbb,, hheeaadd,, ffaaccee,, aanndd bbuurrnn injuries that can take years to treat and usually result in signifi- cant lifelong impairment. The burgeoning field of regenerative medicine provides hope for restoring the structure and function of damaged tissues and organs and curing previously untreatable injuries and diseases. The concept of regenerative medicine—in its simplest form—is to replace or regenerate human cells, tissues, or organs to restore or establish normal function. Advanced technologies such as tissue regeneration, bone scaffolding, and stem cell-enabled treatments are needed to revolutionize the clinical rehabilitation of severely injured service members. The Department of Defense established the Armed Forces Institute of Regenerative Medicine (AFIRM) in 2008 with the mission of developing new products and therapies to treat severe injuries suffered by U.S. service members. This multi-institu- tional, interdisciplinary network of scientists has been designed to accelerate the delivery of regenerative medicine therapies for severely injured U.S. service members. Centered around well-established, proven research investigators, the AFIRM has been able to expand the rehabilitative medicine knowledge base, develop models of injury, and test advanced technology products. AFIRM Annual Report 2009 v EEEEEExxxxxxeeeeeeccccccuuuuuuttttttiiiiiivvvvvveeeeee SSSSSSuuuuuummmmmmmmmmmmaaaaaarrrrrryyyyyy of these cells in several AFIRM- The Limb and Digit Salvage Program funded models, including Dr.Rich- Limb and sseeeekkss ttoo ddeevveelloopp nnoovveell ssoolluuttiioonnss uussiinngg ard Clark’s rat hot comb model for rreeggeenneerraattiivvee mmeeddiicciinnee tthhaatt wwiillll aallllooww vviiccttiimmss Digit ooff sseevveerree mmiilliittaarryy oorr cciivviilliiaann ttrraauummaa ttoo burn injury progression at Stony Salvage rreeccoovveerr mmoorree eefffificciieennttllyy aanndd rreelliiaabbllyy ffrroomm Brook University, Dr. Steven tthheeiirr iinnjjuurriieess aanndd rreettaaiinn tthheeiirr lliimmbbss aass tthheeyy Boyce’s engineered skin substitute rreettuurrnn ttoo pprroodduuccttiivvee lliiffee.. at the University of Cincinnati, and AA ttoottaall ooff 1199 pprroojjeeccttss wweerree ffuunnddeedd iinn Dr. Thomas Mustoe’s rabbit ear YYeeaarr11.. PPrroojjeeccttss ssppaann tthhee ffoolllloowwiinngg cclliinniiccaall scarring model at Northwestern cchhaalllleennggee aarreeaass:: BBoonnee,, SSoofftt TTiissssuuee,, aanndd University. Nerve Repair/Regeneration; Composite Tissue Injury Repair; Transplantation; and First Year Research Highlights Epimorphic Regeneration. Although the program has only recently entered its second year of funding, research efforts have Creating Partnerships and Scarless Wound Healing, Burn already yielded a substantial Collaborations Repair, and Compartment Syn- number of noteworthy accom- The AFIRM’s success to date can drome. Nearly 60 projects have plishments. Dr. Maria Siemionow be ascribed at least in part to the been funded by the AFIRM to date. and colleagues at the Cleveland program’s emphasis on establish- A Program Synergy Group has Clinic (Craniofacial Reconstruc- ing partnerships and collabora- been established to identify col- tion Program) demonstrated the tions. The AFIRM is a five-way laborative opportunities and build clinical feasibility of reconstruct- partnership among the U.S. Army, bridges between the programs and ing tissue loss in the face following Navy, and Air Force, the Veterans projects. One example of a suc- severe trauma by completing the Health Administration, the Defense cessful collaborative effort among first near-total face transplant in a Health Program, and the National scientists working on different civilian patient in the United States. Institutes of Health. The AFIRM AFIRM projects is found in the Drs.William Wagner and Johnny is composed of two independent Burn Repair Program. Dr. Arnold Huard at the Stem Cell Research research consortia working with Caplan and colleagues at Case Center in Pittsburgh (Compart- the U.S. Army Institute of Surgi- Western Reserve University are ment Syndrome Program) created cal Research. One consortium is developing bone marrow-derived an abdominal wall defect model led by the Wake Forest Institute mesenchymal stem cells. They in the rat for the assessment of for Regenerative Medicine and are testing the therapeutic effects biodegradable scaffolds they are the McGowan Institute for Regenerative Medicine in Pittsburgh (WFPC) while The Craniofacial Reconstruction Program the other is led by Rutgers – Craniofacial aaiimmss ttoo ggeenneerraattee bbootthh ssoofftt aanndd hhaarrdd the State University of New ttiissssuueess tthhrroouugghh nnoovveell rreeggeenneerraattiivvee Reconstruction Jersey and the Cleveland mmeeddiicciinnee aapppprrooaacchheess ttoo rreedduuccee tthhee Clinic (RCCC). Each consor- iimmppaacctt ooff ddeevvaassttaattiinngg,, ddiissfifigguurriinngg ffaacciiaall tium contains approximately iinnjjuurriieess oonn wwoouunnddeedd wwaarrrriioorrss.. 15 member organizations, A total of 11 projects were funded in which are mostly academic Year 1. Projects span the following institutions. clinical challenge areas: Bone and Soft Tissue Regeneration, Skeletal Muscle Research activities are orga- and Nerve Replacement, Cartilage nized into five program areas: Regeneration (with a focus on the ear), Limb and Digit Salvage, and Virtual Modeling. Craniofacial Reconstruction, vi AFIRM Annual Report 2009 scientists—over the first year of the The Scarless Wound Healing Program program, 36 awards/honors were Scarless eennccoommppaasssseess aa ccoonnttiinnuuuumm ooff tteecchhnnoollooggiieess conferred upon AFIRM faculty, aaiimmeedd aatt tthhee vvaarriioouuss ssttaaggeess ooff wwoouunndd Wound hheeaalliinngg ttoo fifinndd nneeww ttrreeaattmmeenntt ooppttiioonnss ttoo including awards from private foun- Healing pprreevveenntt aanndd mmaannaaggee ssccaarrss.. dations, selection to membership or leadership positions in profes- AA ttoottaall ooff 77 pprroojjeeccttss wweerree ffuunnddeedd iinn sional societies, honorary degrees YYeeaarr1. Projects span the following clinical challenge areas: Control of Wound from academic institutions, and Environment Mechanics, Therapeutic awards for distinguished careers Molecular/Gene Delivery to Wounds, from government agencies. Their Attenuation of Wound Inflammatory AFIRM-related research efforts Response, and Scar Mitigation. have substantially contributed to the scientific literature—over the first year of the program, they pub- developing for treating compart- They are refining this bandage so lished 59 articles in peer-reviewed ment syndrome. Dr.W.P. Andrew that it will maintain an acute wound journals and produced 118 pre- Lee and colleagues at the Univer- in a pro-regenerative state and pre- sentations and non-peer-reviewed sity of Pittsburgh (Limb and Digit vent the onset of scarring, fibrosis, publications. AFIRM scientists Salvage Program) performed hand and infection. have also been making novel pat- transplantation on a former Marine The projects highlighted in the entable discoveries in the field of who lost his hand in a training preceding paragraphs are just a few regenerative medicine—over the accident while on active duty. The examples of a long list of research first year of the program, they filed patient is now, at 4 months after the developments and successes result- 27 invention disclosures, of which 6 transplant, on a minimal immuno- ing from AFIRM-funded laborato- have resulted in government patent suppression regimen without any ries over the past year. applications filed. adverse side effects. Engineered skin substitutes, which First Year Program Highlights From the Laboratory to the consist of various types of skin cells The AFIRM involves the efforts Battlefield attached to a collagen-based matrix, of nearly 300 individuals, includ- AFIRM-funded researchers share a are being developed and tested clin- ing faculty members, postdoctoral strong commitment to developing ically as an adjunctive treatment for fellows, graduate students, scien- commercial products and bringing burn repair. Drs.Steven Boyce and tific and technical staff, and under- therapies to wounded warriors and Dorothy Supp at the University of graduate students. AFIRM faculty the civilian sector as quickly as pos- Cincinnati (Burn Repair Program) members are highly accomplished sible. The ultimate goal of AFIRM- established advanced engineered skin substitute models with skin pigmentation and a supply of blood The Burn Repair Program seeks to vessels. Drs. Geoffrey Gurtner, Burn ddeessiiggnn iinnnnoovvaattiivvee rreeggeenneerraattiivvee mmeeddiicciinnee Michael Longaker, and Anthony tthheerraappiieess ffoorr vviiccttiimmss ooff sseevveerree mmiilliittaarryy oorr Repair cciivviilliiaann ttrraauummaa ssoo tthheeyy ccaann rreeccoovveerr ffrroomm Oro at Stanford University (Scar- tthheeiirr iinnjjuurriieess wwiitthh iimmpprroovveedd ffuunnccttiioonn aanndd less Wound Healing Program) capi- aaeesstthheettiiccss.. talized on the ability of wounded fetal tissue to regenerate with A total of 15 projects were funded in Year 1. Projects span the following clinical minimal scarring by developing a challenge areas: Intravenous Treatment regenerative bandage containing of Burn Injury, Topical Treatment of Burn a fetal-like matrix and stem cells Injury, Wound Healing and Scar Prevention, derived from human amniotic fluid. and Skin Products/Substitutes. AFIRM Annual Report 2009 vii